Top Strategies for Dieting With Diabetes

Medically Reviewed by Jennifer Robinson, MD on October 28, 2015
From the WebMD Archives

Q. How can weight loss help me manage diabetes? What are the top weight loss strategies you recommend?

A. You don't have to lose a lot of weight to see a big improvement in diabetes. Trimming just 5% to 10% of your body weight will help you feel better, gain more control over the condition, and reduce the amount of medicines you take. And if you can lose weight within 5 years of getting diagnosed, you may be able to reverse it.

My first tip would be to talk with your doctor about diabetes drugs. Some medicines that control your blood sugar, like glipizide (Glucotrol) and glyburide (DiaBeta), can make you gain weight. A better option may be a drug like metformin (Glucophage) or sitagliptin (Januvia), which will help you manage diabetes and lose a few pounds. Or you can try a newer diabetes medicine like liraglutide (Saxenda, Victoza), which will help you feel full so you may eat less. Exenatide (Bydureon, Byetta) and canagliflozin (Invokana) can also help you lose weight.

Some drugs you take to control blood pressure can hinder your efforts to lose weight, so check with your doctor to make sure yours isn't undermining your weight loss goals.

Diet and exercise should be a big part of your weight loss strategy. The goal with diet is to reduce the number of calories you eat each day. In general, women should eat 1,200 to 1,500 calories, and men should get 1,500 to 1,800 calories per day. Try adding extra protein from healthy sources like fish, chicken, and yogurt. Protein will fill you up for a longer period of time than carbs.

Exercise can help you lose weight (and keep it off), control your blood sugar, and manage diabetes. Do any activity that will help you burn 2,500 calories a week. That's equal to a brisk walk 1 hour a day for 5 days of the week. Learn how to start an exercise plan with diabetes.

If you still struggle to lose weight and you have a body mass index (BMI) higher than 27 along with diabetes, ask your doctor about a weight loss drug such as phentermine and topiramate (Qsymia), lorcaserin (Belviq), or naltrexone and bupropion (Contrave). Along with diet and exercise, these medicines can help you lose at least another 5% of your body weight.

If your BMI is over 35, weight loss surgery is an option. Ask your doctor about the various techniques. These aren't a magic weight loss fix, though. You'll still need to change your lifestyle with healthy eating and exercise.

A newer alternative to surgery is VBLOC, which uses an implanted pacemaker-like device to block the nerve that regulates hunger, making you feel fuller sooner.

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Caroline M. Apovian, MD, director of nutrition and weight management, Boston Medical Center.

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